Maryland: New outpatient injectable drug requirements

Effective Nov. 1, 2021, prior authorization will be required for the drugs listed below and in the code list for UnitedHealthcare Community Plan of Maryland members:

  • Adakveo®
  • Crysvita®
  • Evenity®
  • Exondys 51®
  • Fasenra®
  • Gamifant®
  • Givlaari®
  • Ilumya™
  • Kalbitor®
  • Luxturna®
  • Onpattro®
  • Radicava®
  • Reblozyl®
  • Tepezza®
  • Ultomiris®
  • Vyepti®
  • Vyondys 53®

If you administer any of these medications without first completing the prior authorization process, the claim may be denied. Members can’t be billed for services denied due to failure to complete the prior authorization process.

You can submit prior authorization requests:

  • Online: Use the Prior Authorization and Notification tool on UHCprovider.com

To view the clinicalpolicies for these drugs, go to Medical & Drug Policies and Coverage Determination Guidelines.

Questions?

Call the Provider Services phone number on the member’s health care identification card.

PCA-1-21-02518-C&S-LTR